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The Neurological Legacy of Childhood Trauma

It’s almost common knowledge that many people who experienced trauma as children have a harder time in adult life. Indeed, over the past few decades, well-designed studies have verified this impression by finding that a great number of such people really do have a greater chance of depression, anxiety, or other psychological disorders, behavioral and social problems, and poorer health outcomes.

Less well known is that trauma – even in the absence of physical trauma– can have negative impacts on the brain itself that last into adulthood.

Studies on the neurological effects of stress and trauma have consistently shown structural and functional neurological changes, though the specific nature of these changes is currently unclear. A consistent theme, however, is that trauma especially affects one of the body’s key stress response systems, the HPA (hypothalamic-pituitary-adrenal) axis. For example, the hippocampus, a brain region involved in memory and emotion and rich in receptors for stress hormones, has been shown to be smaller in traumatized adults – including adults traumatized as children – than in those without such history.

Children can be traumatized not only by the same things that can traumatize adults – for example, direct physical/sexual abuse, natural disasters, or events related to war – but also by experiences that would likely affect an adult differently or not at all, such as neglect, verbal aggression, witnessing abuse within the family, a chaotic home environment, or inadequate nutrition. In a way, this stands to reason, because these experiences may subvert the critical developmental stages a child passes through on the way to adulthood.

Better understanding the neurological and psychological mechanisms by which adverse childhood experiences can lead to adult dysfunction could help inform and improve practices in prevention, intervention, and treatment. Because children will, as adults, be members of a family, a community, a workforce, a government, and a population, it is critical that research continue and, most importantly, that the findings be translated and applied in real settings.

I invite readers to comment below with their thoughts, or with links or other information, that others might find useful or interesting.

Further reading:

Child Welfare Information Gateway (2008) Long-Term Consequences of Child Abuse and Neglect. US Department of Health and Human Services.

McCrory E, et al. (2011) The Impact of Childhood Maltreatment: A Review of Neurobiological and Genetic Factors. Front Psychiatry 2: 48. doi:10.3389/fpsyt.2011.00048 []

Spenrath MA, et al. (2011) The Science of Brain and Biological Development: Implications for Mental Health Research, Practice, and Policy. J Can Acad Child Adolesc Psychiatry 20: 298-304.

UNICEF. Focus area: Young child survival and development.

US Centers for Disease Control. The Adverse Childhood Experiences (ACE) Study.

  1. What you write is true; I have experienced it. However, you leave out one important point, which arguably wasn’t in the scope of your article: As we mature, we are also the products of our choices. While I still feel the effects of multiple childhood traumas/neglect, I also function better than lots (and lots) of other people and have a joy now that such a “neurological legacy” cannot alter.

  2. Thank you for this wonderful information. Being an adult who experienced much trauma as a child I can certainly relate to this blog.
    I consider myself one of the fortunate ones because I’m on a healing path. One thing I notice is how strong my story is and how addicted to chaos and drama I am. Practicing mindfulness in life and learning to be awake to my moments has helped me to keep taking a step back and pay attention to what’s going on.
    I write about my journey in my blog and would like to use a few excerpts from your writings. May I do this? I will attribute anything of yours to you.
    Thanks again for putting this info out there.

  3. I couldn’t agree more. Dr. Allan Schore of UCLA has been relentlessly supporting this message in his writings since 1994 with his book, Afflect Regulation and the Origin of the Self, which was the original impetus for my understanding of the origins of a fractured sense of self. I use this background to explain the creative process in great poets who were able to access creative language by dissociative means. All of them suffered trauma. I invite you to read my articles on my Web site’s publication page. My blog has shorter pieces with a broader reach. Raising children with great care and respect is fundamental to their mental health. Thank you for your attention to this and for the recent cites which I will read with great interest.

  4. An intriguing article. Both my wife and I both sustained clearly remembered
    psychic and physical trauma from our parents when we were very young. In
    our better moments, it is clear that this underlies much of our often severe
    anxieties, self-doubt, depression etc. At other times, it is hard not to blame
    ourselves for ‘having been born weak or broken’ or some similar self laceration.
    We also suspect that we in particular may have come into the world with
    higher sensitivities or sensibilities, which under better circumstances could
    have been blessings, but within certain family cultures made us unusually
    vulnerable to things other children might have survived equably. I can only
    hope that, eventually, stronger, more direct therapeutic modes will come
    down the pipeline to strengthen the HPA pathways you mention.

  5. Thanks for making that point, why. It is a very important one that I regrettably omitted because of the necessary brevity of the post. There’s work being done and evidence being published on neurological plasticity, meaning remodeling, and presumably healing. It’s known that with some treatments the hippocampus can return to normal size after chronic stress leaves it “injured.” The hippocampus itself seems to be the brain region that is not only the richest in stress hormone receptors but one of the most capable of healing itself! So, this is a huge and complex topic that really isn’t possible to boil down to a single mechanistic explanation or a single model. The most important thing is to know that trauma can be healed, and that no situation is completely hopeless.

  6. Thanks, Brenda! Great that you’re finding healing in the aftermath of adversity, and that you’re learning that healing is possible!

    You’re more than welcome to excerpt this post or any on the Speaking of Medicine blog. All our content is, as is that in our journal, PLoS Medicine, licensed under an open access agreement (Creative Commons CC-BY) rather than traditional copyright law. This means you can “distribute, remix, tweak, and build upon” the work, as long as you credit the author for the original work. For more information on this important alternative to traditional copyright restrictions please see

  7. Thanks for your thoughts, Carole. Please feel free to distribute this post or any other on the Speaking of Medicine blog, as it’s all under the Creative Commons CC-BY open access license agreement, which is focused on maximum dissemination and use of content.

    All the best to you in your endeavors!

  8. Gene, thanks for sharing that. I want to emphasize that I’m no expert on this matter, and the blog post contains only a small slice of what’s known and what’s being done in this area right now. This is an enormously complex topic that involves not only the brain but the social and physical environments, genetics, and so much more. Trauma, even encountered long in the past, can heal, and it’s very much worth not losing hope over.

  9. All of the above comments recognize the genetic predispositions involved as well as the possibility of repair of the self that I see in the poets I study. The wounded genius is not just a cliché. Maggie, I didn’t know about the possible repair of the hippocampus when stress is removed. That is valuable information. Thanks!

  10. Does anyone have experiences with the approach of Klaus Grawe who was a Swiss psychotherapist doing a lot of research on “Neuropsychologie” (the German wording for psychology based on neurological networks)? I loved reading his books …

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